Individual
JASARAH NICOLE BALDWIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCASA, LCMHCA
Contact information
Practice address
3750 MEADOW VIEW RD, LUMBERTON, NC 28358-1920
(910) 618-9912
(910) 618-0728
Mailing address
2230 MCPHAIL RD APT 3D, LUMBERTON, NC 28358-8024
(910) 366-9927
(910) 618-0728
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
26460
NC
101YM0800X
Mental Health Counselor
Primary
A16375
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0727
—
NC
Enumeration date
03/19/2021
Last updated
03/19/2021
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